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Female reproductive history in relation to chronic obstructive pulmonary disease and lung function in UK biobank: a prospective population-based cohort study

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Female reproductive history in relation to chronic obstructive pulmonary disease and lung function in UK biobank : a prospective population-based cohort study. / Tang, Rosalind; Fraser, Abigail; Magnus, Maria Christine.

In: BMJ Open, Vol. 9, No. 10, e030318, 28.10.2019.

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@article{65d2f2e493fc43989161878cf728d4ec,
title = "Female reproductive history in relation to chronic obstructive pulmonary disease and lung function in UK biobank: a prospective population-based cohort study",
abstract = "Objectives: Sex differences in respiratory physiology and predilection for developing chronic obstructive pulmonary disease (COPD) have been documented, suggesting that female sex hormones may influence pathogenesis. We investigated whether aspects of female reproductive health might play a role in risk of COPD among women.Design: Population-based prospective cohort study.Setting: UK Biobank recruited across 22 centres in the United Kingdom between 2006-2010.Primary and secondary outcomes measures: We examined a range of female reproductive health indicators in relation to risk of COPD-related hospitalisation/death (n=271 271) using Cox proportional hazards regression; and lung function (n=273 441) using linear regression.Results: Parity >3 was associated with greater risk of COPD-related hospitalisation/death (adjusted HR 1.45; 95{\%} CI: 1.16, 1.82) and lower FEV 1/FVC (adjusted mean difference -0.06; 95{\%} CI: -0.07, -0.04). Any oral contraception use was associated with lower risk of COPD-related hospitalisation/death (adjusted HR 0.85; 95{\%} CI: 0.74, 0.97) and greater FEV1/FVC (adjusted mean difference 0.01; 95{\%} CI: 0.003, 0.03). Late menarche (age >15) and early menopause (age <47) were also associated with greater risk of COPD-related hospitalisation/death (but not lung function), while endometriosis was associated with greater FEV 1/FVC (not COPD-related hospitalisation/death). Early menarche (age <12 years) was associated with lower FEV 1/FVC (but not COPD hospitalisation/death). Associations with PCOS or ovarian cysts; any HRT use; hysterectomy-alone; and both hysterectomy and bilateral oophorectomy were in opposing directions for COPD-related hospitalisation/death (greater risk) and FEV 1/FVC (positive association).Conclusions: Multiple female reproductive health indicators across the life course are associated with COPD-related hospitalisation/death and lung function. Further studies are necessary tounderstand the opposing associations of PCOS/ovarian cysts, HRT and hysterectomy with COPD and objective measures of airway obstruction.",
keywords = "chronic obstructive pulmonary disease, hormone replacement therapy, menarche, menopause, oral contraceptives, spirometry",
author = "Rosalind Tang and Abigail Fraser and Magnus, {Maria Christine}",
year = "2019",
month = "10",
day = "28",
doi = "10.1136/bmjopen-2019-030318",
language = "English",
volume = "9",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "10",

}

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TY - JOUR

T1 - Female reproductive history in relation to chronic obstructive pulmonary disease and lung function in UK biobank

T2 - a prospective population-based cohort study

AU - Tang, Rosalind

AU - Fraser, Abigail

AU - Magnus, Maria Christine

PY - 2019/10/28

Y1 - 2019/10/28

N2 - Objectives: Sex differences in respiratory physiology and predilection for developing chronic obstructive pulmonary disease (COPD) have been documented, suggesting that female sex hormones may influence pathogenesis. We investigated whether aspects of female reproductive health might play a role in risk of COPD among women.Design: Population-based prospective cohort study.Setting: UK Biobank recruited across 22 centres in the United Kingdom between 2006-2010.Primary and secondary outcomes measures: We examined a range of female reproductive health indicators in relation to risk of COPD-related hospitalisation/death (n=271 271) using Cox proportional hazards regression; and lung function (n=273 441) using linear regression.Results: Parity >3 was associated with greater risk of COPD-related hospitalisation/death (adjusted HR 1.45; 95% CI: 1.16, 1.82) and lower FEV 1/FVC (adjusted mean difference -0.06; 95% CI: -0.07, -0.04). Any oral contraception use was associated with lower risk of COPD-related hospitalisation/death (adjusted HR 0.85; 95% CI: 0.74, 0.97) and greater FEV1/FVC (adjusted mean difference 0.01; 95% CI: 0.003, 0.03). Late menarche (age >15) and early menopause (age <47) were also associated with greater risk of COPD-related hospitalisation/death (but not lung function), while endometriosis was associated with greater FEV 1/FVC (not COPD-related hospitalisation/death). Early menarche (age <12 years) was associated with lower FEV 1/FVC (but not COPD hospitalisation/death). Associations with PCOS or ovarian cysts; any HRT use; hysterectomy-alone; and both hysterectomy and bilateral oophorectomy were in opposing directions for COPD-related hospitalisation/death (greater risk) and FEV 1/FVC (positive association).Conclusions: Multiple female reproductive health indicators across the life course are associated with COPD-related hospitalisation/death and lung function. Further studies are necessary tounderstand the opposing associations of PCOS/ovarian cysts, HRT and hysterectomy with COPD and objective measures of airway obstruction.

AB - Objectives: Sex differences in respiratory physiology and predilection for developing chronic obstructive pulmonary disease (COPD) have been documented, suggesting that female sex hormones may influence pathogenesis. We investigated whether aspects of female reproductive health might play a role in risk of COPD among women.Design: Population-based prospective cohort study.Setting: UK Biobank recruited across 22 centres in the United Kingdom between 2006-2010.Primary and secondary outcomes measures: We examined a range of female reproductive health indicators in relation to risk of COPD-related hospitalisation/death (n=271 271) using Cox proportional hazards regression; and lung function (n=273 441) using linear regression.Results: Parity >3 was associated with greater risk of COPD-related hospitalisation/death (adjusted HR 1.45; 95% CI: 1.16, 1.82) and lower FEV 1/FVC (adjusted mean difference -0.06; 95% CI: -0.07, -0.04). Any oral contraception use was associated with lower risk of COPD-related hospitalisation/death (adjusted HR 0.85; 95% CI: 0.74, 0.97) and greater FEV1/FVC (adjusted mean difference 0.01; 95% CI: 0.003, 0.03). Late menarche (age >15) and early menopause (age <47) were also associated with greater risk of COPD-related hospitalisation/death (but not lung function), while endometriosis was associated with greater FEV 1/FVC (not COPD-related hospitalisation/death). Early menarche (age <12 years) was associated with lower FEV 1/FVC (but not COPD hospitalisation/death). Associations with PCOS or ovarian cysts; any HRT use; hysterectomy-alone; and both hysterectomy and bilateral oophorectomy were in opposing directions for COPD-related hospitalisation/death (greater risk) and FEV 1/FVC (positive association).Conclusions: Multiple female reproductive health indicators across the life course are associated with COPD-related hospitalisation/death and lung function. Further studies are necessary tounderstand the opposing associations of PCOS/ovarian cysts, HRT and hysterectomy with COPD and objective measures of airway obstruction.

KW - chronic obstructive pulmonary disease

KW - hormone replacement therapy

KW - menarche

KW - menopause

KW - oral contraceptives

KW - spirometry

UR - http://www.scopus.com/inward/record.url?scp=85074259761&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2019-030318

DO - 10.1136/bmjopen-2019-030318

M3 - Article

C2 - 31662371

AN - SCOPUS:85074259761

VL - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 10

M1 - e030318

ER -